Provider Demographics
NPI:1710180617
Name:SUAREZ, RONALD OSCAR (LMT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:OSCAR
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7522 CLEVES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-3422
Mailing Address - Country:US
Mailing Address - Phone:813-504-1332
Mailing Address - Fax:
Practice Address - Street 1:7522 CLEVES AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-3422
Practice Address - Country:US
Practice Address - Phone:813-504-1332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA30519225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist